磁吻合技术及应用  

Definition and application of magnetic compression anastomosis

作　　者：张谞丰[1,2,3] 卢强[1,2,3] 李宇[1,2,3] 白纪纲[1,2,3] 张晓刚[1,2,3] 张欣 樊超[1,2,3] 李建辉[2,3,5] 刘学民[1,2,3] Xufeng Zhang;Qiang Lu;Yu Li;Jigang Bai;Xiaogang Zhang;Xin Zhang;Chao Fan;Jianhui Li;&Xuemin Liu(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;National Local Joint Engineering Research Center for Precision Surgery&Regenerative Medicine,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering,the First Affiliated Hospital of Xi’an Jiaotong University,Xi’an 710061,China;High Magnetic Field Laboratory,Hefei Institutes of Physical Science,Chinese Academy of Sciences,Hefei 230031,China;Department of Surgical Oncology,Shaanxi Provicial People’s Hospital,Xi’an 710068,China)

机构地区：[1]西安交通大学第一附属医院肝胆外科,西安710061 [2]西安交通大学第一附属医院精准外科与再生医学国家地方联合工程研究中心,西安710061 [3]西安交通大学第一附属医院陕西省再生医学与外科工程研究中心,西安710061 [4]中国科学院合肥物质科学研究院,强磁场科学中心,合肥230031 [5]陕西省人民医院肿瘤外科,西安710068

出　　处：《科学通报》2020年第13期1173-1180,共8页Chinese Science Bulletin

基　　金：国家自然科学基金(81470896,81700545,30830099,81127005,51275387);陕西省技术创新引导专项(2017CGZH-HJ-14)资助。

摘　　要：磁外科(磁外科学)作为一门新兴的技术型学科,以其广泛的应用前景得到了全世界众多研究者的关注.磁外科技术按照其应用方式和原理的不同分为以下5大类:磁压榨技术、磁导航技术、磁锚定技术、磁悬浮技术以及磁示踪技术.其中,磁压榨技术利用磁力的特殊性质来完成临床上某些特定的操作,如脏器的连接再通、组织的压榨闭合、管腔内容物的限流等.磁吻合技术作为磁压榨技术的重要分支,其本质是利用磁力代替缝线和钛钉的牵拉力来完成组织管腔吻合或再通的技术.目前,磁吻合在临床中主要应用于以下3个领域:消化道管腔吻合、消化道闭塞/狭窄的再通以及血管吻合.磁力消化道管腔可应用于不同消化道管腔之间的吻合,将消化道管腔吻合由传统的"贯穿式"吻合转变成"非贯穿"吻合,极大地简化了操作,降低了术后并发症.针对消化道管腔闭塞/狭窄疾病,磁吻合技术为此类疾病提供了一种新的治疗策略,无需通过开腹或者开胸便可完成管腔的再通,极大地减轻了病人的创伤以及手术相关并发症的发生,甚至可以为某些传统方法无法治疗的疾病提供解决方案.除此之外,磁吻合技术还可应用于血管的端-端、端-侧以及侧-侧吻合,吻合过程操作简便,可在极短的时间内完成器官血流的重建,缩短了靶器官的缺血或瘀血时间,使得术后并发症显著减少,该技术已在冠脉搭桥、门腔分流以及器官移植等手术中成功应用.磁性装置的表面改性处理以及外形设计是磁吻合技术在临床应用的两大关键问题.磁性装置的表面改性方案主要取决于其在生物体内停留的时间,而磁性装置的外形设计主要取决于拟吻合管腔局部的解剖因素和磁体导入途径以及吻合所需要的磁力大小.鉴于磁吻合技术在管腔吻合以及管腔闭塞疏通中的巨大应用潜质,未来磁吻合技术将在为其他腔道(输尿�As a new technical discipline, magnetic surgery(MS) has attracted attention of many researchers all over the world for its broad application prospects in the diagnosis and treatment of diseases. MS can be grouped as the following five categories according to different applications and principles: Magnetic compression technique(MCT), magnetic navigation technique(MNT), magnetic anchor technique(MCT), magnetic levitation technique(MLT) and magnetic tracer technique(MTT).Among these techniques, the magnetic compression anastomosis can be used to accomplish certain surgical procedures through the special properties between magnetic materials, such as lumen anastomosis and recanalization, closure of abnormal channels between tissues or organs and restriction anomalous flow of lumen contents. Since being first described in 1978 by Obora, magnetic anastomosis has been initially attempted in treatment of esophageal atresia and diverticula,diversion of gastrointestinal tract, and recanalization of the biliary stricture. Because of the encouraging and broad perspective of magnetic anastomosis in clinical medicine, a new word "magnamosis" has been recommended by Dr.Michael Harrison, one of the leading scientists in this field. Magnetic anastomosis, as an important branch of magnetic compression anastomosis, is essentially a technique that uses magnetic force to transform the lumen anastomosis from the conventional "penetrating" anastomosis to a novel "non-penetrating" anastomosis to greatly simplify the procedure and reduce the rate of postoperative complications. For patients with gastrointestinal lumen occlusion or stenosis, magnetic anastomosis provides a new treatment strategy. This new method can complete the recanalization of digestive tract lumen under intervention method, and avoid major operations, such as laparotomy or thoracotomy. As such, magnetic anastomosis can greatly reduce surgical trauma, as well as incidence of postoperative complications. In addition, magnetic anastomosis can provide treatment options fo

关 键 词：磁吻合 磁压榨技术 磁外科 管腔重建 

分 类 号：R454.1[医药卫生—治疗学] R616[医药卫生—临床医学]